Larotrectinib interactions
Full monograph for LarotrectinibCheck it against another medicine
Medicines
357 documented
Mechanism
| Medicine | Severity | Mechanism | Effect | Sources |
|---|---|---|---|---|
| Apalutamide | Major | Metabolism | Coadministration with potent inducers of CYP450 3A4 and/or P-glycoprotein (P-gp) may significantly decrease the plasma concentrations of larotrectinib, which… | 5 sources — open the full entry |
| Carbamazepine | Major | Metabolism | Coadministration with potent inducers of CYP450 3A4 and/or P-glycoprotein (P-gp) may significantly decrease the plasma concentrations of larotrectinib, which… | 5 sources — open the full entry |
| Ceritinib | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of larotrectinib, which is primarily metabolized by… | 6 sources — open the full entry |
| Clarithromycin | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of larotrectinib, which is primarily metabolized by… | 6 sources — open the full entry |
| Enzalutamide | Major | Metabolism | Coadministration with potent inducers of CYP450 3A4 and/or P-glycoprotein (P-gp) may significantly decrease the plasma concentrations of larotrectinib, which… | 5 sources — open the full entry |
| Esomeprazole + Amoxicillin + Clarithromycin | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of larotrectinib, which is primarily metabolized by…2 documented mechanisms | 10 sources — open the full entry |
| Fosphenytoin Sodium | Major | Metabolism | Coadministration with potent inducers of CYP450 3A4 and/or P-glycoprotein (P-gp) may significantly decrease the plasma concentrations of larotrectinib, which… | 5 sources — open the full entry |
| Itraconazole | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of larotrectinib, which is primarily metabolized by… | 6 sources — open the full entry |
| Ketoconazole | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of larotrectinib, which is primarily metabolized by… | 6 sources — open the full entry |
| Ketoconazole + Zinc Pyrithione + Aleovera | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of larotrectinib, which is primarily metabolized by… | 6 sources — open the full entry |
| Lansoprazole + Amoxicillin + Clarithromycin | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of larotrectinib, which is primarily metabolized by… | 6 sources — open the full entry |
| Leflunomide | Major | Synergy | The recent, concomitant, or subsequent use (without the recommended leflunomide washout period or procedure) of other agents known to induce hepatotoxicity may… | 3 sources — open the full entry |
| Lopinavir + Ritonavir | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of larotrectinib, which is primarily metabolized by…2 documented mechanisms | 7 sources — open the full entry |
| Mifepristone | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of larotrectinib, which is primarily metabolized by… | 6 sources — open the full entry |
| Mifepristone + Misoprostol | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of larotrectinib, which is primarily metabolized by… | 6 sources — open the full entry |
| Nelfinavir | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of larotrectinib, which is primarily metabolized by… | 6 sources — open the full entry |
| Nirmatrelvir + Ritonavir | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of larotrectinib, which is primarily metabolized by… | 6 sources — open the full entry |
| Phenobarbital | Major | Metabolism | Coadministration with potent inducers of CYP450 3A4 and/or P-glycoprotein (P-gp) may significantly decrease the plasma concentrations of larotrectinib, which… | 5 sources — open the full entry |
| Phenytoin Sodium | Major | Metabolism | Coadministration with potent inducers of CYP450 3A4 and/or P-glycoprotein (P-gp) may significantly decrease the plasma concentrations of larotrectinib, which… | 5 sources — open the full entry |
| Posaconazole | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of larotrectinib, which is primarily metabolized by… | 6 sources — open the full entry |
| Primidone | Major | Metabolism | Coadministration with potent inducers of CYP450 3A4 and/or P-glycoprotein (P-gp) may significantly decrease the plasma concentrations of larotrectinib, which… | 5 sources — open the full entry |
| Rabeprazole + Amoxicillin + Clarithromycin | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of larotrectinib, which is primarily metabolized by… | 6 sources — open the full entry |
| Rifampicin | Major | Metabolism | Coadministration with potent inducers of CYP450 3A4 and/or P-glycoprotein (P-gp) may significantly decrease the plasma concentrations of larotrectinib, which… | 5 sources — open the full entry |
| Rifampicin + Isoniazid | Major | Metabolism | Coadministration with potent inducers of CYP450 3A4 and/or P-glycoprotein (P-gp) may significantly decrease the plasma concentrations of larotrectinib, which…2 documented mechanisms | 9 sources — open the full entry |
| Rifampicin + Isoniazid + Pyrazinamide + Ethambutol | Major | Metabolism | Coadministration with potent inducers of CYP450 3A4 and/or P-glycoprotein (P-gp) may significantly decrease the plasma concentrations of larotrectinib, which…2 documented mechanisms | 9 sources — open the full entry |
| Tucatinib | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of larotrectinib, which is primarily metabolized by… | 6 sources — open the full entry |
| Vonoprazan + Amoxicillin + Clarithromycin | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of larotrectinib, which is primarily metabolized by…2 documented mechanisms | 9 sources — open the full entry |
| Voriconazole | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of larotrectinib, which is primarily metabolized by… | 6 sources — open the full entry |
| Abemaciclib | Moderate | Metabolism | Coadministration with inhibitors of CYP450 3A4 may increase the plasma concentrations of abemaciclib and its pharmacologically active metabolites, all of which… | 2 sources — open the full entry |
| Abiraterone Acetate | Moderate | Metabolism | Coadministration with inhibitors of CYP450 3A4, P-glycoprotein (P-gp), and/or breast cancer resistance protein (BCRP) may increase the plasma concentrations of… | 4 sources — open the full entry |
| Acalabrutinib | Moderate | Metabolism | Coadministration with inhibitors of CYP450 3A4 may increase the plasma concentrations of acalabrutinib, which is primarily metabolized by the isoenzyme. | 3 sources — open the full entry |
| Acyclovir + Hydrocortisone | Moderate | Metabolism | Coadministration with larotrectinib may increase the plasma concentrations of drugs that are substrates of the CYP450 3A4 isoenzyme. | 4 sources — open the full entry |
| Albendazole | Moderate | Metabolism | Coadministration with larotrectinib may increase the plasma concentrations of drugs that are substrates of the CYP450 3A4 isoenzyme. | 4 sources — open the full entry |
| Alfuzosin Hydrochloride | Moderate | Metabolism | Coadministration with larotrectinib may increase the plasma concentrations of drugs that are substrates of the CYP450 3A4 isoenzyme. | 4 sources — open the full entry |
| Alpelisib | Moderate | Metabolism | Coadministration with inhibitors of CYP450 3A4, P-glycoprotein (P-gp), and/or breast cancer resistance protein (BCRP) may increase the plasma concentrations of… | 4 sources — open the full entry |
| Alprazolam | Moderate | Metabolism | Coadministration with larotrectinib may increase the plasma concentrations of drugs that are substrates of the CYP450 3A4 isoenzyme. | 4 sources — open the full entry |
| Amiodarone Hydrochloride | Moderate | Metabolism | Coadministration with inhibitors of CYP450 3A4, P-glycoprotein (P-gp), and/or breast cancer resistance protein (BCRP) may increase the plasma concentrations of… | 4 sources — open the full entry |
| Amlodipine Besilate | Moderate | Metabolism | Coadministration with larotrectinib may increase the plasma concentrations of drugs that are substrates of the CYP450 3A4 isoenzyme. | 4 sources — open the full entry |
| Amlodipine Besilate + Atenolol | Moderate | Metabolism | Coadministration with larotrectinib may increase the plasma concentrations of drugs that are substrates of the CYP450 3A4 isoenzyme. | 4 sources — open the full entry |
| Amlodipine Besilate + Atorvastatin | Moderate | Metabolism | Coadministration with larotrectinib may increase the plasma concentrations of drugs that are substrates of the CYP450 3A4 isoenzyme.2 documented mechanisms | 75 sources — open the full entry |
| Amlodipine Besilate + Benazepril Hydrochloride | Moderate | Metabolism | Coadministration with larotrectinib may increase the plasma concentrations of drugs that are substrates of the CYP450 3A4 isoenzyme. | 4 sources — open the full entry |
| Amlodipine Besilate + Olmesartan Medoxomil | Moderate | Metabolism | Coadministration with larotrectinib may increase the plasma concentrations of drugs that are substrates of the CYP450 3A4 isoenzyme. | 4 sources — open the full entry |
| Amlodipine Besilate + Telmisartan | Moderate | Metabolism | Coadministration with larotrectinib may increase the plasma concentrations of drugs that are substrates of the CYP450 3A4 isoenzyme. | 4 sources — open the full entry |
| Amlodipine Besilate + Valsartan | Moderate | Metabolism | Coadministration with larotrectinib may increase the plasma concentrations of drugs that are substrates of the CYP450 3A4 isoenzyme. | 4 sources — open the full entry |
| Apixaban | Moderate | Metabolism | Coadministration with inhibitors of CYP450 3A4 and/or P-glycoprotein (P-gp) may increase the plasma concentrations of apixaban, which is a substrate of both… | 2 sources — open the full entry |
| Aprepitant | Moderate | Metabolism | Coadministration with inhibitors of CYP450 3A4, P-glycoprotein (P-gp), and/or breast cancer resistance protein (BCRP) may increase the plasma concentrations of… | 4 sources — open the full entry |
| Aripiprazole | Moderate | Metabolism | Coadministration with inhibitors of CYP450 3A4 and/or 2D6 may increase the plasma concentrations of aripiprazole, which is primarily metabolized by these… | 5 sources — open the full entry |
| Armodafinil | Moderate | Metabolism | Coadministration with inducers of CYP450 3A4 and/or P-glycoprotein (P-gp) may decrease the plasma concentrations of larotrectinib, which is primarily… | 14 sources — open the full entry |
| Artemether + Lumefantrine | Moderate | Metabolism | Coadministration with larotrectinib may increase the plasma concentrations of drugs that are substrates of the CYP450 3A4 isoenzyme.3 documented mechanisms | 7 sources — open the full entry |
| Asciminib | Moderate | Metabolism | Coadministration with inhibitors of CYP450 3A4, P-glycoprotein (P-gp), and/or breast cancer resistance protein (BCRP) may increase the plasma concentrations of… | 3 sources — open the full entry |
Food & lifestyle
grapefruit juice
ModerateMetabolism
Grapefruit juice may increase the plasma concentrations of larotrectinib. The proposed mechanism is inhibition of CYP450 3A4-mediated metabolism of larotrectinib by certain compounds present in grapefruit.
What to do: Larotrectinib may be taken with or without food. Patients should avoid the consumption of grapefruit and grapefruit juice during treatment.
1 source
- "Product Information. Vitrakvi (larotrectinib)." Bayer Pharmaceutical Inc (2018):
Conditions
Conditions in which Larotrectinib needs care, as documented in this source.
Liver Failure
ModerateForty- five percent of the patients receiving larotrectinib had increased hepatic parameters, including Grade 3 increased AST or ALT in 6% of patients. Monitor liver tests, including ALT and AST, every 2 weeks during the first month of treatment, then monthly thereafter, and as clinically indicated. Treatment should be withheld or permanently discontinued based on the severity of hepatic toxicity. Caution is advised in patients with moderate to severe hepatic impairment as the drug clearance was reduced in these patients (Child-Pugh B and C). Dose should be reduced on these patients as recommended by the manufacturers (refer to prescribing information).
1 source
- "Product Information. Vitrakvi (larotrectinib)." Bayer Pharmaceutical Inc (2018):